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The US Supreme Court's decision in Director, Office of Workers' Compensation Programs v. Greenwich Collieries, defining burden of proof in section 7(c) of the Administrative Procedure Act (APA) as meaning a burden of persuasion, cancelled fifty years of precedence regarding the true doubt rule. The Court's decision fundamentally shifted the approach plaintiffs will need to take when bringing black lung disease cases. Plaintiffs can expect greater expenses and evidentiary burdens in pursuing their cases.

The US Supreme Court considered the definition of the criminal law concept 'beyond a reasonable doubt' during the 1993-94 term in the consolidated cases of Victor v. Nebraska and Sandoval v. California. The court found the jury instructions on reasonable doubt constitutional in both cases but expressed dissatisfaction with ambiguous definitions of the requisite standard of proof.